- Hypertrophic - Just as our skeletal muscles hypertrophy (grow in size) in response to increased demand, cardiac muscle undergoes hypertrophy when placed under a high workload for a prolonged period of time. Some cardiac hypertrophy is normal and reversible, such as that seen in athletes and pregnant women. Pathologic hypertrophy is the result of diseases that place increased demand on the heart, such as chronic hypertension, myocardial infarction, and valvular damage. Left ventricular hypertrophy (LVH) is the most common type of hypertrophic heart disease. A common cause of LVH is chronic hypertension, which increases the afterload on the left ventricle. This means the left ventricle has to increase contractility and/or preload to maintain the same stroke volume. Over time the added stress on the left ventricular myocardium results in muscle hypertrophy and re-modeling of the left ventricle to a less efficient size and shape. This leads to a diminishing ejection fraction (EF), meaning the heart must work even harder to maintain cardiac output. The larger heart also demands more blood flow, and so becomes more susceptible to ischemic injury.
- Coronary artery disease and heart attacks.
- Alcohol abuse.
- Viral myocarditis.
- Postpartum cardiomyopathy.
- In many cases, no cause can be identified, which is called Idiopathic cardiomegaly.
- Shortness of breath [SOB].
- Heart palpitations.
- Fluid retention.
- Chest x-ray - this allows the cardiologist to see the overall shape and size of the heart and lungs.Cardiomegaly is often detected on an anteroposterior chest x-ray (AP CXR). and it involves measuring the distance from the midline of the spine to the most lateral aspect of the cardiac apex, and adding this distance to that found from the same midline to the most lateral aspect of the right atrium. This number is then divided by the largest horizontal width of the chest, from right to left pleural surface. This value is known as the cardiothoracic ratio (CTR). A CTR > 0.5 indicates cardiomegaly.
- Echocardiogram - sound waves sent to a special machine present a picture of the beating heart, so the doctor can see the heart as its chambers contract and relax.
- Doppler study - shows blood flow through the heart valves and evaluates whether the valves are functioning normally.
- Electrocardiogram - measures electrical activity in the heart and can assess heart rhythm and evidence of old infarction or ischemia.
- Regular cardiovascular exercise.
- Adopting a low-fat diet.
- Dietary adjustments to reduce blood cholesterol levels.
- Frequent medical check-ups to make sure the treatments are working.
- Implantable cardioverter-defibrillator (ICD). A device implanted in the chest can electrically restart the heart if it stops beating. Some devices can also stimulate the heart to pump more effectively.
- Heart replacement: In very few people with Cardiomegaly and severe congestive heart failure, Heart transplant may be recommended.
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